Immobilization Is Best for Severe Ankle Sprains

Severe ankle sprains sometimes lead to chronic instability or other long-term problems. Although most other ligamentous injuries (e.g., shoulder, knee) are temporarily immobilized, recent guidelines for ankle sprains discourage immobilization and recommend early weight-bearing and progressive exercise.

Researchers randomized 584 emergency department patients (age, >16) with severe acute ankle sprains (unable to bear weight for at least 3 days) to standard treatment with double-layer tubular compression bandages or immobilization with one of three devices: removable Aircast (allowing plantar flexion and dorsiflexion but limiting inversion and eversion), removable Bledsoe boot (limiting motion in all planes), or nonremovable below-knee cast (f…